Department of Ophthalmology, New York University School of Medicine, New York, USA.
A 42-year-old man with a history of human immunodeficiency virus and previous immune reconstitution after initiating a highly active antiretroviral therapy regimen was referred to rule out cytomegalo-virus retinitis. He had an unusual juxtapapillary collection of white superficial material and multiple preretinal collections resting on a peripheral ground glass opacification of the retina. These lesions quickly resolved after initiating treatment for syphilitic retinitis. The patient appeared to have developed an exaggerated response to the ocular syphilitic infection that may be related to the augmentation of his impaired immune system by highly active antiretroviral therapy.